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Sen. Cassidy plans to bring down Medicaid

Sen. Cassidy plans to bring down Medicaid

Sen. Bill CassidyBill CassidyRepublicans see Becerra as next target in confirmation wars Overnight Health Care: Johnson & Johnson vaccine safe, effective in FDA analysis | 3-4 million doses coming next week | White House to send out 25 million masks Koch-backed group launches ads urging lawmakers to reject COVID-19 relief bill MORE (R-La.) deserves some credit.

When other Republicans hid over the May congressional recess, Cassidy was one of only two Senate Republicans to hold a town hall — where he took questions from those angry over congressional efforts to repeal and replace the Affordable Care Act. Given that he was shouted down at a February town hall he had to know the May forum wouldn’t be easy.

And Cassidy, a gastroenterologist, has at least tried to come up with concrete ideas to replacing the Affordable Care Act. Initially he partnered with moderate Sen. Susan CollinsSusan Margaret CollinsMedia circles wagons for conspiracy theorist Neera Tanden Why the 'Never-Trumpers' flopped Republicans see Becerra as next target in confirmation wars MORE (R-Maine). His current effort is actually prime-sponsored by Sen. Lindsey GrahamLindsey Olin GrahamOvernight Defense: Biden sends message with Syria airstrike | US intel points to Saudi crown prince in Khashoggi killing | Pentagon launches civilian-led sexual assault commission Graham: Trump will 'be helpful' to all Senate GOP incumbents John Boehner tells Cruz to 'go f--- yourself' in unscripted audiobook asides: report MORE (R-S.C.), and also co-sponsored by Sen. Dean HellerDean Arthur HellerOn The Trail: Democrats plan to hammer Trump on Social Security, Medicare Lobbying World Democrats spend big to put Senate in play MORE (R-Nev.), and Sen. Ron JohnsonRonald (Ron) Harold JohnsonGraham: Trump will 'be helpful' to all Senate GOP incumbents Partisan headwinds threaten Capitol riot commission Cruz hires Trump campaign press aide as communications director MORE (R-Wis.).

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Regrettably, practice hasn’t made perfect. The latest bill would not only convert into fixed block grants the federal monies made available to states for Medicaid expansion, but would also, as has been true of other Republican efforts, attack the “traditional” Medicaid that pre-dates the ACA.

 

It would do so by converting the federal matching of state funding into a hard cap per Medicaid beneficiary, with that cap, over time, starving funding for those with disabilities and the elderly in long-term care settings. In this regard it resembles the failed Better Care Reconciliation Act offered by Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellTrump at CPAC foments 2022 GOP primary wars Hawley gets boisterous ovation at CPAC for Electoral College objection   Why Congress must invoke the 14th Amendment now MORE (R-Ky).

Over a decade, my little state of New Hampshire would lose $410 million, according to one analysis updated today, while Cassidy’s Louisiana would lose a staggering $3.2 billion. The co-sponsorship by Heller, who has managed to be on all sides of ACA repeal — at one point incurring a threat from President Trump and attacks from a Trump-sanctioned group — suggests he has lost all interest in being re-elected, as Nevada would lose $639 million.

The legislation would create disparate winners and losers, with no apparent logic as to how heavily its ax falls. In an exclusive to Breitbart News, Utah Gov. Gary Herbert praised the bill as “a vast improvement over the Affordable Care Act” — his state would actually gain $313 million from current federal Medicaid funding by robbing other states. 

Cassidy has airily dismissed the necessity of a Congressional Budget Office analysis, saying “I just don’t care about the coverage numbers,” claiming the CBO’s methodology is inaccurate. He has also expressed no worry over the fact that under his bill the block grants would cease in 2027 and require congressional reauthorization.

In remarks last month before the Press Club of Baton Rouge, Cassidy made it clear that the ACA was perhaps the least of his concerns — stating that “the traditional Medicaid program is a huge problem.” His candor reveals an objective to cut the Medicaid program, dating to 1965, that serves millions of seniors across the United States in nursing homes and in home-and-community-based settings for less than actual cost. Hardly out-of-control, Medicaid spending on nursing home care only went up 1.1 percent nationally in 2015. 

Cassidy did note that he had carved out “blind and disabled children” from the bill’s cuts.  As my association represents a 26-bed facility for children with profound disabilities, I should perhaps be grateful for this magnanimity on Cassidy’s part, but can’t help but worry about this latest attack upon over 4,100 Medicaid patients in our nursing homes in a state with the nation’s second-oldest population.

Time is running out for Cassidy. The Senate parliamentarian has ruled that a repeal and replacement can only pass using budget reconciliation, which takes just 50 votes, through September 30.

Brendan Williams is the president/CEO of the New Hampshire Health Care Association, which represents 90 long-term care facilities. Williams is also an attorney, former Washington state deputy insurance commissioner and former Washington state representative.